Cathy McMullan does not look like a woman who would be at risk of heart disease. And she certainly does not look like a woman who had a silent heart attack a few short months ago, but that is exactly what doctors believe has happened.

Cathy works at Stormont and in March 2017, Northern Ireland Chest Heart and Stroke were invited to trial their new Well You programme amongst staff there. Well You is a 12 week programme which aims to support and encourage people to make lifestyle changes. It includes a Well Check at the start and end of the 12 weeks – a health check that assesses cardiovascular risk factors such as blood pressure, cholesterol and body composition (BMI).

Cathy tells us what happened; “I’d had a health check with NICHS before and my blood pressure had never been high but this time there were lots of red warning lights coming up throughout the Well Check, including my blood pressure. I was a little overweight at the time, not getting enough exercise and relaxing with a drink most evenings – the glasses of wine with dinner were adding up. Something had to be done.”

Over the following twelve weeks, Cathy made a number of lifestyle changes, encouraged by the weekly emails sent out by the Well You team. “Knowing that NICHS would be back for another check-up in twelve weeks kept me focused.”

She cut out alcohol completely, and with it all the empty calories and extra snacks. She joined a slimming initiative through her work and has, to date, lost 1.5 stones. She also took on an allotment. “Very few people know it but there are allotments on Stormont Estate. So I took one on and regularly spend 30 minutes digging at lunchtime. At first the weeds and brambles were taller than me but over the months I have tamed it and can now grow vegetables. As well as good exercise, it is an excellent form of mindfulness. I leave my desk and all the issues of my job behind and just focus on nature.”

At the end of twelve weeks, the Well You team returned and Cathy was pleased to find that her weight, physical activity levels and alcohol consumption had all improved. However, despite these improvements, her blood pressure had actually gone up. “The top figure (systolic) was high but the bottom figure (diastolic) was off the scale!”

Cathy continues, “It made no sense and it bothered me a little. Actually, no, it bothered me more than a little. It bothered me so much that I went to the open surgery at my GP the next day.

“My GP sent me to the treatment room for blood tests and for an ECG (electrocardiogram). When the ECG was completed, instead of being told I was fine, I was kept there. The GP was called back in and started asking what I would call heart attack type questions.

“But I’d not experienced any noticeable symptoms such as chest pains; maybe a little indigestion but nothing noteworthy. However, the ECG results were indicating that I’d had a heart attack in the previous few weeks.”

Cathy was immediately put on calcium blockers for her blood pressure and statins, though her cholesterol was not high. As the cardiac event was in the past, Cathy was not sent to hospital immediately. A few weeks later she went for an ECG treadmill test, where there were no signs of angina. An Echocardiogram followed and this showed she has a slightly leaky heart valve.

In the end, Cathy says, “The doctors can’t conclusively say whether I did or did not have a heart attack. But the leaky valve indicates that this is a possibility as that damage can be caused by a heart attack. Most importantly, they will continue to monitor my heart with regular Echocardiograms in the future

Despite the lack of a definitive answer, Cathy has a very positive viewpoint and is an advocate for health checks. “I think it is marvellous my employer offers services such as NICHS’s Well You in the workplace. It is incredibly convenient and I doubt that I would have gone for any health checks otherwise.

“Without Well You, I would not have had the motivation to make the lifestyle changes I did. And if I hadn’t made those changes and seen the results, the lack of improvement in my blood pressure would not have been obvious. I would have had no idea that I was at risk of or indeed had had a heart attack.

“My message to everyone is to get checked. Know your blood pressure and your cholesterol. A doctor would not have picked me out as a likely candidate for a heart attack and yet look what happened. Get checked!”